Field of the Invention
The present invention relates to a medical treatment and, more particularly, to a system and method of using hyperbaric oxygen therapy to treat concussive symptoms and musculoskeletal injuries and for pre-treatment to prevent injuries, including neural damage from concussions.
Description of the Related Art
Professional athletes continue to lose valuable playing time and risk future health concerns from both the immediate trauma and the secondary effects of concussion incidents. Since 1996, the National Football League has collected data on the clinical signs, symptoms, medical actions and management of concussions in order to improve player safety. Data collected from 1996-2001 showed that of 1200 concussed players, 353 (29.4%) experienced repeat concussions. Information for the years 2002-2007 followed a similar pattern with 854 concussions and 154 suffering repeat head trauma.
The injuries and losses of players throughout a season have a significant impact on professional sports organizations. Specifically, the loss of players and participants in the National Hockey League (NHL), National Football League (NFL) and the World Boxing Federation (WBF) due to head trauma is significant. For example, in 2011 the NFL had a reported 122 players who missed games due to concussions costing NFL owners an estimated combined salary loss of over $7,320,000. The long term effects of head trauma leading to Chronic Brain Injury (CBI) have also drastically changed the approach to the safety of injured players, which has had an additional significant cost impact to professional sports organizations.
A concussion is a mild traumatic brain injury (mTBI). It is defined as a traumatically induced transient disturbance in brain function that involves a complex pathophysiological process. The blow or impulse force results in a neurometabolic cascade of pathophysiological events including ionic, metabolic and anatomic disturbances which lead to microscopic neuronal cell injury. This cascade of pathophysiological events 10 will now be described in connection with FIG. 1. More particularly, after an injury (step 20) to the brain, the inflammatory response causes the activation of microglial cells (step 30). Activated microglia release pro-inflammatory cytokines (step 40), which initially are productive in healing, but too much or repeated activation can be detrimental to the healing process. In particular, the release of pro-inflammatory cytokines in step 40 can cause blood vessels to leak (step 50), thus increasing pressure and decreasing oxygen to the cells (step 60). Decreased oxygen to the cells causes ischemia (step 70) to the brain cells which, if prolonged, causes cell death (step 80) and impairment (step 90). Therefore, activated microglia can lead to impaired recovery, neuronal death after the brain insult and a more severe final end state of the injury (step 95).
Most concussion symptoms last 24 to 72 hours in normal adults, but can last longer depending on the severity of the brain injury. The majority of concussions (80%-90%) resolve within 7-10 days. Symptoms that can be experienced during the recovery period are headache, dizziness and slight confusion. These symptoms result from the neurometabolic cascade of chemicals (10 of FIG. 1) released in response to injury sustained from the initial impact of the concussion discussed in connection with FIG. 1. These symptoms and the fear of exasperating the injury with early physical or cognitive activity or the exponential damage from a second impact injury during the recovery period are the major cause of time lost for the professional athlete.
Brain injuries are usually classified as mild, moderate or severe. These classifications are usually determined clinically by duration of loss of consciousness (LOC) and post-traumatic amnesia (PTA) following injury. For a “mild” classification the individual will usually have an LOC of less than 30 minutes and PTA of less than 1 day. With a “moderated” classification an individual will usually have an LOC of greater than 30 minutes but less than 24 hours and a PTA of 1 to 7 days. Severe brain injury can present with an LOC of greater than 24 hours and a PTA of more than 7 days.
According to the Walton Foundation over 5.3 million Americans are suffering some type of disability following a mTBI. The final disability is based on the severity of the initial injury and or repeated blows to the head over a period of several months or years. The symptoms of CBI are debilitating, long term and range from behavioral conflicts such as anxiety, depression and overwhelming sense of frustration to constant irritability and suicidal thoughts. There are cognitive issues as well that range from decreased short and long term memory and difficulty learning to overall poor judgment, insight and planning.
Some studies have looked at hyperbaric oxygen therapy (HBOT) for the treatment of mTBI. Those studies have had mixed results. In the majority of studies involving human subjects with mTBI, the subjects were treated with HBOT long after the damage had taken effect on the brain tissue, at which point the damage is most likely irreversible.
One of the failures of the current treatment of mTBI with HBOT is the delay in which the treatment is provided. Most HBOT treatments for mTBI have attempted to heal tissue already permanently damaged. See, for example, Some cases attempted to treat people who had severe head trauma and HBOT was not initiated until 72 months after injury. No studies, however, have tried to decrease or stop the initial cascade effects of a concussion in humans, which is the cause of most damage to the brain.
Additionally, HBOT has been attempted to treat musculoskeletal injuries, again long after the injuries have become permanent. See, for example, Russian Patent Application Publication No. RU2010117594 to Pulatovich.
The inventors of the present invention believe that managing the cascade effect is crucial to stopping the initial damage and providing the opportunity for a faster recovery. Accordingly, there is a need in the art for a new and improved system and method of treating concussive symptoms with hyperbaric oxygen therapy, wherein the initial cascade effect is curtailed before permanent impairment can occur.